The proposed research is a competing continuation of a randomized efficacy trial to evaluate the Early Intervention Foster Care Program (EIFC). EIFC is a preventive intervention that is specifically designed to address the needs of preschool-aged foster children and their caregivers. By the completion of the first 5 years of funding, we will have collected data on 180 children and their caregivers (120 children randomly assigned to the EIFC condition or to the regular foster care comparison condition;60 no maltreated low income community children) over a 24-month assessment protocol. Analyses of data to date support the efficacy of the intervention and confirm the conceptual model that has guided the investigation in a number of areas. Of particular note, the EIFC intervention increases the use of positive parenting strategies by caregivers, improves subsequent placement outcomes (e.g., stable reunifications with birth families and adoptions), reduces problem behavior, and positively impacts a number of other domains of child functioning through preschool and into the kindergarten and first-grade years. These outcomes indicate that, with the support of well-trained and supervised foster parents, significant risk reduction among foster preschoolers is possible. However, the ongoing risks faced by children who enter foster care at an early age are considerable, and it is unclear whether the gains we have observed among children in the intervention group will be sustained. The proposed continuation will allow us to follow the sample into middle childhood and to test hypotheses specified by the conceptual model regarding outcomes across five domains, including psychosocial adjustment, school performance, functioning of specific stress regulatory neural systems, service utilization, and long-term placement outcomes. We will also examine mechanisms (e.g., parenting practices and intervention dosage/adherence) that may mediate a range of positive/negative outcomes in this population. Finally, we will conduct an economic evaluation to examine how the benefits of the program compare to the costs. We propose to follow the sample over a 24-month period. Four waves of data collection are proposed at 6-month intervals, beginning at 48 months post baseline assessment. By the end of the study, the children will be 9-12 years old.